The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review
IntroductionAlcohol use disorder (AUD) is the most prevalent substance use disorder (SUD) globally. In 2019, AUD affected 14.5 million Americans and contributed to 95,000 deaths, with an annual cost exceeding 250 billion dollars. Current treatment options for AUD have moderate therapeutic effects an...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-04-01
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| Series: | Frontiers in Psychiatry |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1141836/full |
| _version_ | 1827958923294932992 |
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| author | Charlotte E. Goldfine Jeremiah J. Tom Dana D. Im Benjamin Yudkoff Amit Anand Joseph J. Taylor Joseph J. Taylor Peter R. Chai Peter R. Chai Peter R. Chai Joji Suzuki |
| author_facet | Charlotte E. Goldfine Jeremiah J. Tom Dana D. Im Benjamin Yudkoff Amit Anand Joseph J. Taylor Joseph J. Taylor Peter R. Chai Peter R. Chai Peter R. Chai Joji Suzuki |
| author_sort | Charlotte E. Goldfine |
| collection | DOAJ |
| description | IntroductionAlcohol use disorder (AUD) is the most prevalent substance use disorder (SUD) globally. In 2019, AUD affected 14.5 million Americans and contributed to 95,000 deaths, with an annual cost exceeding 250 billion dollars. Current treatment options for AUD have moderate therapeutic effects and high relapse rates. Recent investigations have demonstrated the potential efficacy of intravenous ketamine infusions to increase alcohol abstinence and may be a safe adjunct to the existing alcohol withdrawal syndrome (AWS) management strategies.MethodsWe followed Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines to conduct a scoping review of two databases (PubMed and Google Scholar) for peer-reviewed manuscripts describing the use of ketamine in AUD and AWS. Studies that evaluated the use of ketamine in AUD and AWS in humans were included. We excluded studies that examined laboratory animals, described alternative uses of ketamine, or discussed other treatments of AUD and AWS.ResultsWe identified 204 research studies in our database search. Of these, 10 articles demonstrated the use of ketamine in AUD or AWS in humans. Seven studies investigated the use of ketamine in AUD and three studies described its use in AWS. Ketamine used in AUD was beneficial in reducing cravings, alcohol consumption and longer abstinence rates when compared to treatment as usual. In AWS, ketamine was used as an adjunct to standard benzodiazepine therapy during severe refractory AWS and at signs of delirium tremens. Adjunctive use of ketamine demonstrated earlier resolution of delirium tremens and AWS, reduced ICU stay, and lowered likelihood of intubation. Oversedation, headache, hypertension, and euphoria were the documented adverse effects after ketamine administration for AUD and AWS.ConclusionThe use of sub-dissociative doses of ketamine for the treatment of AUD and AWS is promising but more definitive evidence of its efficacy and safety is required before recommending it for broader clinical use. |
| first_indexed | 2024-04-09T15:43:34Z |
| format | Article |
| id | doaj.art-e0c8f5a0b1ae4051a4e4530d9f78cc62 |
| institution | Directory Open Access Journal |
| issn | 1664-0640 |
| language | English |
| last_indexed | 2024-04-09T15:43:34Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Psychiatry |
| spelling | doaj.art-e0c8f5a0b1ae4051a4e4530d9f78cc622023-04-27T05:34:17ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402023-04-011410.3389/fpsyt.2023.11418361141836The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping reviewCharlotte E. Goldfine0Jeremiah J. Tom1Dana D. Im2Benjamin Yudkoff3Amit Anand4Joseph J. Taylor5Joseph J. Taylor6Peter R. Chai7Peter R. Chai8Peter R. Chai9Joji Suzuki10Department of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesCenter for Brain Circuit Therapeutics, Brigham and Women’s Hospital, Boston, MA, United StatesDepartment of Emergency Medicine, Brigham and Women’s Hospital, Boston, MA, United StatesThe Fenway Institute, Fenway Health, Boston, MA, United StatesKoch Institute for Integrated Cancer Research, Massachusetts Institute of Technology, Boston, MA, United StatesDepartment of Psychiatry, Brigham and Women’s Hospital, Boston, MA, United StatesIntroductionAlcohol use disorder (AUD) is the most prevalent substance use disorder (SUD) globally. In 2019, AUD affected 14.5 million Americans and contributed to 95,000 deaths, with an annual cost exceeding 250 billion dollars. Current treatment options for AUD have moderate therapeutic effects and high relapse rates. Recent investigations have demonstrated the potential efficacy of intravenous ketamine infusions to increase alcohol abstinence and may be a safe adjunct to the existing alcohol withdrawal syndrome (AWS) management strategies.MethodsWe followed Preferred Reporting Items for Systematic Reviews (PRISMA) guidelines to conduct a scoping review of two databases (PubMed and Google Scholar) for peer-reviewed manuscripts describing the use of ketamine in AUD and AWS. Studies that evaluated the use of ketamine in AUD and AWS in humans were included. We excluded studies that examined laboratory animals, described alternative uses of ketamine, or discussed other treatments of AUD and AWS.ResultsWe identified 204 research studies in our database search. Of these, 10 articles demonstrated the use of ketamine in AUD or AWS in humans. Seven studies investigated the use of ketamine in AUD and three studies described its use in AWS. Ketamine used in AUD was beneficial in reducing cravings, alcohol consumption and longer abstinence rates when compared to treatment as usual. In AWS, ketamine was used as an adjunct to standard benzodiazepine therapy during severe refractory AWS and at signs of delirium tremens. Adjunctive use of ketamine demonstrated earlier resolution of delirium tremens and AWS, reduced ICU stay, and lowered likelihood of intubation. Oversedation, headache, hypertension, and euphoria were the documented adverse effects after ketamine administration for AUD and AWS.ConclusionThe use of sub-dissociative doses of ketamine for the treatment of AUD and AWS is promising but more definitive evidence of its efficacy and safety is required before recommending it for broader clinical use.https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1141836/fullketaminealcohol use disorderalcohol withdrawal syndromealcohol abstinenceclinical trials |
| spellingShingle | Charlotte E. Goldfine Jeremiah J. Tom Dana D. Im Benjamin Yudkoff Amit Anand Joseph J. Taylor Joseph J. Taylor Peter R. Chai Peter R. Chai Peter R. Chai Joji Suzuki The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review Frontiers in Psychiatry ketamine alcohol use disorder alcohol withdrawal syndrome alcohol abstinence clinical trials |
| title | The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review |
| title_full | The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review |
| title_fullStr | The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review |
| title_full_unstemmed | The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review |
| title_short | The therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome: a scoping review |
| title_sort | therapeutic use and efficacy of ketamine in alcohol use disorder and alcohol withdrawal syndrome a scoping review |
| topic | ketamine alcohol use disorder alcohol withdrawal syndrome alcohol abstinence clinical trials |
| url | https://www.frontiersin.org/articles/10.3389/fpsyt.2023.1141836/full |
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